Individual
DR. NANCY SIERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
268 DR MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-2011
(973) 877-5000
Mailing address
66 W GILBERT ST, TINTON FALLS, NJ 07701-4918
(732) 212-0060
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA05590000
NJ
208D00000X
General Practice Physician
25MA05590000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1167901
—
NJ
01
—
17960
UHP NON PAR #
NJ
01
—
60039170-NON PAR
HORIZONNJHEALTH
NJ
01
—
P00601224
RAILROAD MEDICARE
NJ
Enumeration date
09/16/2005
Last updated
07/28/2009
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